Article Text

Download PDFPDF

Incidence and pathogenesis of megaloblastic erythropoiesis in multiple myeloma
  1. A. V. Hoffbrand1,
  2. J. R. Hobbs,
  3. S. Kremenchuzky,
  4. D. L. Mollin
  1. Department of Haematology, Royal Postgradute Medical School, Ducane Road, London
  2. Department of Chemical Pathology, Royal Postgradute Medical School, Ducane Road, London
  3. Medical Research Council Group for Investigation into Megaloblastic and Sideroblastic Anaemias


    Intermediate megaloblastic changes occurred in six (19%) of 32 patients with multiple myeloma and trivial megaloblastic changes in a further ten (31%). Folate deficiency was the predominant cause of these changes and in at least two patients was sufficiently severe to contribute to anaemia. Folate deficiency appeared to be due to exćess folate utilization by the tumour and was related to the amount of paraprotein produced daily.

    Five of the 32 patients had subnormal serum B12 levels. Reduction in the serum B12 level was related to the reduction in the normal circulating immunoglobulins and occurred despite normal B12 absorption. Possible explanations for this finding are discussed.

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


    • 1 Present address: Department of Haematology, St. Bartholomew's Hospital, London E.C.1.